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Reimbursement in Endoscopy: How Can New Procedures Be Implemented?

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      Abstract

      Background: New procedures in endoscopy take time to be incorporated in the German diagnosis-related groups (DRG) system. Depending on the extent of innovation and the costs, several pathways are possible. Methods: This article provides an overview of possible pathways to implement new procedures in the German DRG payment system. Additionally, we compare the results of 2 surveys on the system of New Diagnostic and Treatment Methods (Neue Untersuchungs- und Behandlungsmethoden; NUB). Furthermore, the pathways of 2 innovations in endoscopy are described in detail and compared with the possibilities within the legal framework. Results: The different pathways like NUB applications or DRG change requests and the underlying legal framework are described in detail. The results of a survey from 2007 on the daily practice of NUB funding in Germany show that the extent of innovations which receive a positive assessment (status 1) is 46% compared to 43.7% in a survey from 2007, and that 77% of the status 1 procedures (and drugs) can be negotiated into a payment - compared to 53% in the older survey. Conclusion: Medical scientific societies should be involved in this process from the beginning. Besides the importance for the hospital application process (81.3% of all medical controllers want to have society support), the regulatory bodies (e.g. DIMDI, InEK, G-BA) also appreciate scientific statements. Two examples show the pathways in detail. For radiofrequency ablation of Barrett's esophagus, the pathway of continuous change requests was chosen, while the endoluminal conduit for the treatment of type 2 diabetes was established as NUB payment.

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      Positionspapier der Fachgesellschaften zur Anwendungsempfehlung der endoskopischen biliodigestiven Diversion in Deutschland – DDG/DGAV/DGVS –

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        Editorial Comments Introducing New Technology A Stepwise Algorithm

         H Malchau (2000)
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          Author and article information

          Affiliations
          inspiring-health - Dr. Wilke GmbH, Munich, Germany
          Journal
          VIS
          VIS
          10.1159/issn.2297-4725
          Visceral Medicine
          Visc Med
          S. Karger GmbH (Freiburg, Germany karger@ 123456karger.de http://www.karger.de )
          978-3-318-05805-5
          978-3-318-05806-2
          2297-4725
          2297-475X
          February 2016
          09 February 2016
          : 32
          : 1
          : 29-35
          VIS2016032001029
          10.1159/000443652
          27588293
          PMC4988247 Visc Med 2016;32:29-35
          © 2016 S. Karger GmbH, Freiburg

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Counts
          Figures: 5, Tables: 5, References: 10, Pages: 7
          Categories
          Review Article

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